CAJ | 학술논문

目的:探讨重症急性胰腺炎(SAP)凝血功能紊乱与病情严重度及预后的关系.方法:选取发病24 h内的轻型胰腺炎(MAP)组46例,SAP组44例,另选40例健康成年人作对照组,检测血浆凝血酶原时间(PT)、部分活化凝血酶原时间(APTT)、纤维蛋白原(FIB)和D-二聚体(D-D),比较其主要凝血指标的差异及主要凝血指标异常与病情严重度(APACHEⅡ)评分的关系.结果:SAP组与对照组、MAP组比较,PT、APTT、FIB及D-D差异有显著性(P<0.05);AP伴全身炎症反应综合征(SIRS)组与不伴SIRS组比较有显著性差异(P<0.01);SAP组FIB及D-D值与APACHEⅡ评分均存在直线相关关系(P<0.05).结论:SAP患者存在血浆凝血功能紊乱,凝血功能障碍与急性胰腺炎严重度存在相关性,凝血和纤溶指标的检测对判断预后及评估病情严重度有一定指导意义.
목적:탐토중증급성이선염(SAP)응혈공능문란여병정엄중도급예후적관계.방법:선취발병24 h내적경형이선염(MAP)조46례,SAP조44례,령선40례건강성년인작대조조,검측혈장응혈매원시간(PT)、부분활화응혈매원시간(APTT)、섬유단백원(FIB)화D-이취체(D-D),비교기주요응혈지표적차이급주요응혈지표이상여병정엄중도(APACHEⅡ)평분적관계.결과:SAP조여대조조、MAP조비교,PT、APTT、FIB급D-D차이유현저성(P<0.05);AP반전신염증반응종합정(SIRS)조여불반SIRS조비교유현저성차이(P<0.01);SAP조FIB급D-D치여APACHEⅡ평분균존재직선상관관계(P<0.05).결론:SAP환자존재혈장응혈공능문란,응혈공능장애여급성이선염엄중도존재상관성,응혈화섬용지표적검측대판단예후급평고병정엄중도유일정지도의의.
Objective To explore the relationship between coagulation dysfunction and severity and progno?sis in severe acute pancreatitis. Methods Ninety patients with acute pancreatitis who had been admitted to hospital within 24 h were divided into mild acute pancreatitis(MAP) group(46 cases) and severe acute pancreatitis (SAP) group(44 cases). There were 40 healthy people in the control group.Plasma concentrations of the pro?thrombin time(PT),fibrinogen(FIB) and D-dimer(D-D) were detected . The differences of coagulation markers be?tween the two groups were analyzed,and the relationship between coagulation markers and the severity (24 h APACHEⅡ) was studied. Results Plasma concentrations of PT ,APTT, FIB and D-D in SAP group were sig?nificantly different as comparing MAP group and control group(P<0.05).There was significant difference be?tween SIRS group and no SIRS group (P<0.01). There was significant correlation between FIB and D-D and APACHEⅡscore in SAP group(P<0.05). Conclusion Dysfunction of coagulation and microcirculation distur?bances can be found in patients with severe acute pancreatitis. The detection of major parameters correlating with thromboxane and fibrinolysis is important for the judgement of the prognosis of patients and evaluation of the severity of the disease.